When considering a CT scan for children, alternative imaging procedures, radiation safety measures and parent education should be “top priorities” for medical imaging professionals, the American Society of Radiologic Technologists (ASRT) reported in its scientific journal, Radiologic Technology.

Researchers from Shawnee State University and Midwestern State University examined dozens of peer-reviewed journal articles published within the last 10 years along with online information about CT and its effects on the pediatric and adult populations.

“The literature review was initially an assignment for a research course. However, due to the increased awareness on the topic of radiation safety for pediatric patients during CT exams in recent years, the assignment expanded to focus on ways to most effectively minimize the dose,” Kristina Darnell, M.S., R.T.(R)(CT)(MR), coauthor of the study, told HCB News.
Throughout the studies they reviewed, the researchers found that lowering the risk of radiation dose during a CT scan was repeatedly prioritized, and they believe substituting CT scans for MR or ultrasound should always be considered since they don't use ionizing radiation. It is suggested that radiologists could collaborate with the referring physician to determine what type of procedure might benefit the patient the most.

Four to seven million CT procedures are performed on children each year, and that number has been decreasing due to concerns about radiation exposure to children. The researchers said that the “as low as reasonably achievable” (ALARA) principle and the Image Gently campaign helped create awareness about the need for lowering the dose to children who are being scanned with a CT.

“These kinds of campaigns [Image Gently], appear to be effective in educating the medical community about the importance of considering alternative imaging procedures such as MRI or ultrasound,” said Darnell.

The researchers also report that bismuth shields are not always used in a CT department even though the shields reduce the radiation dose to radiosensitive areas such as the breast, lens of the eye and thyroid.

According to the announcement, studies have found that the dose in radiosensitive areas ranges from 18 percent to 74 percent when bismuth shields are used, yet they are still considered “controversial”, as they may compromise image quality.

In the study, it is recommended that technologists ensure that the shields are positioned correctly and used along with other dose-reduction methods to ensure the best image quality possible while maintaining patient safety.

The researchers from Shawnee State and Midwestern State believe that educating parents about CT is also essential to patient safety because parents sometimes do not understand what is involved in their child’s radiology examination or the risks. When radiologists or pediatricians have a discussion with parents, they can become fully informed.

“Making sure pediatric patients receive high quality care, the best image the first time around and the lowest possible dose during the procedure are incredibly important,” said Darnell. “That's why it's surprising that The Joint Commission recently decided to withdraw its requirements for CT technologists to obtain advanced-level certification and education. The Joint Commission's decision isn't in the best interest of patient safety.”

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